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� <br /> ' CITY'� �P�`� <br /> � Owner: Ci of Centerville 1880 Main St. Centerville MN 55038 Date: A ril 14 2�i1 <br /> For Period: 7 23 2010 to 4 14 2011 R uest No 10 AND FINAL <br /> Bonestroo �ntractor: Forest Lake Contracdn 14777 Lake Dr. Forest Lake MN 55025 <br /> CONTRACTOR'S REQUEST FOR PAYMENT � �'�1 �v �U3 <br /> 2009 STREET IMPROVEMENTS <br /> BONESTR00 FILE NO. 000616-09170-0 <br /> GITY PROJECT NO. 2009.02 <br /> SUMMARY <br /> 1 Original Contract Amount $ 1,351,737.25 <br /> 2 Change Order - Addition $ 54,038.31 <br /> 3 Change Order - Dedudion $ 0.00 <br /> 4 Revised Contract Amount $ 1,405,775.56 <br /> 5 Value Completed to Date $ 1,311,609.71 <br /> 6 Material on Hand $ 0.00 <br /> 7 Amount Earned $ 1,311,609.71 <br /> 8 Less Retainage 0% $ 0.00 <br /> 9 Subtotal $ 1,311,609.71 <br /> 10 Less Amount Paid Previously $ 1,273,002.17 <br /> 11 Liquidated damages - $ 0.00 <br /> 12 AMOUNT DUE THIS REQUEST FOR PAYMEIVT N0. 10 AND FINAL $ 38,607.54 <br /> Forest Lake Contracting and the Owner each acknowledge by signing this final payment that there are no unsettled I <br /> claims as contemplated in 14.09.A.2. of the General Conditions of the Contract. <br /> Recommended for Approval by: <br /> BONESTROO <br /> ��«'< � <br /> Approved by Contractor: Approved by Owner; <br /> FOREST LAKE CONTRACTING CITY OF CENTERVILLE <br /> � v • l/ <br /> Specified Contrad Completion Date: - Date: <br /> 61609770REQ10FinAl.xlsm ��� <br /> ��� <br />